ER
2019-01-26
By the grace of God and the strength of Mom’s great will to live, Mom is alive today. Over and over again it feels like her time is up, and yet she is still with me. I long to feel that I have more control, that with enough vigilance and care and foresight the right decisions will be made, mistakes averted, misunderstandings avoided, and Mom can live forever. Each crisis is an exercise in humility and acceptance. Someday Mom will die and there will be hindsight and helpful souls pointing out would’ve could’ve should’ve that might have changed the sad reality. I would tell that future me that Mom’s life is in God’s hands and doing what seems best in the moment is all that is asked of me.
Mom had a great time with my sister Kimmy with no mishaps except for one fall. When I came back though she was high maintenance. We came back on Saturday, took Kimmy and her kids to the airport on Sunday and hit the week running on Monday with Mom’s Bible study and dialysis. Tuesday school started up again and Mom had a chiropractor appointment in the morning. At lunch her tooth started hurting and the dentist was able to see her that afternoon. They referred her to a root canal specialist the next day who said that nothing was wrong, and we could wait to see if the pain went away.
Wednesday afternoon Mom came home early from dialysis because the needle had infiltrated causing internal muscular bleeding and swelling around her veins. It happens sometimes. She came home and went to bed. Thursday was her primary care physician appointment. He thought she might have fractured her knee during the fall and sent us to get an x-ray.
By Friday I was exhausted. Mike and I had a meeting at the kids’ school which was followed by an appointment with the collision repair shop that had worked on Esther’s car but left the backup sensors broken. I came home ready to spend the afternoon resting and was greeted at the door with a phone call. It was someone from the dialysis clinic.
“I was just calling to see if your mom had been seen by a vein specialist?”
“What?”
“She only had ten minutes of dialysis before she infiltrated, and we don’t want to see her again until she is seen by a doctor.”
I complained that no one had talked to me about this and worried that she hadn’t had a dialysis since Monday.
“Her numbers were good on Wednesday she should be fine until Monday or Tuesday. If she starts coughing, throws up or runs a fever then take her to the emergency room.”
The vein specialist had no Friday afternoon appointments open and couldn’t see her until Monday. Mom was thrilled to have a break from dialysis and a day home from appointments. I watched her all weekend. On Sunday afternoon I found her in the living room gazing at the Christmas tree which was still up.
“Are you okay, Mom?” I asked.
“Yes.”
“What are you doing?”
“I’m looking at the tree.” Her confused expression questioned the purpose of the harassing questions. I told myself to ease up and let her have her moment.
We saw the vein doctor on Monday who was frustrated that there was no communication with him from the dialysis techs. He explained to me how he wanted them to insert the needles, marked up her arm, and gave me a colored ultrasound picture of her veins to pass to the clinic. He performed a procedure to remove a small blockage and told us that her arm was good to go for dialysis that afternoon. Going into the appointment Mom was in great spirits and her blood pressure was normal. She left feeling exhausted and claimed that the procedure had taken a lot out of her.
From there we raced to the clinic and arrived an hour and a half to two hours past her start time. Two people came out of the back room. A woman who I didn’t recognize and a male nurse who I talk to almost every time I’ve come in. I talked about the appointment and tried to explain the doctor’s instructions. They asked me why I hadn’t approached the doctor about doing a more invasive procedure on her arm to make her fistula more user friendly. The answer was that no one had told me about such a procedure. I can’t remember exactly how the conversation went. I didn’t specifically say that she hadn’t had dialysis for a week. I didn’t get down on my knees and beg them to take her back. I wish I had.
They told me that they wouldn’t give her dialysis. I asked if Mom would be okay and the woman said that she had made arrangements for Mom to be seen on Tuesday even though it wasn’t her regular day. As it turns out the nurse I trusted had been on vacation the whole week before. No one told him that Mom hadn’t had dialysis since the previous Monday. He assumed that her visit to the specialist was a routine appointment and wasn’t worried about her missing one day of dialysis. I assumed they didn’t want to do dialysis either because it was so soon after the procedure to remove a blockage or because we were late. I assumed. He assumed. She assumed. Mom was tired as she often is after doctor appointments but showed no other sign of distress. She seemed normal to me.
By eight o’ clock on Monday evening the little kids were all tucked in bed with my phone on their dresser playing the audiobook, “Little House on the Prairie.” I changed into my fuzzy socks and lay down on my bed. Thoughts of laundry and dishes were banished with a longing to watch a movie as often happens when Mike is in San Diego. Instead I picked up a book. I was too tired to feel flustered when Jonah ran downstairs with the phone, eyes wide and told me that Nanama needed me.
The kids don’t always answer the phone when it rings and they are listening to their audiobook. Jonah recognized her picture on the caller ID and had the following conversation.
“Is something wrong?”
“Yes.”
Mom has no memory of making that call.
I went to her room expecting that her CPAP machine mask was twisted or her pill machine was low on batteries. She lay on the bed. Her mask off.
“Momma are you okay?”
“I…can’t…breathe. I need to go to the emergency room.” She was calm. Her breathing was labored, but not in a gasping shortness of breath. Something was wrong, but not knowing that her heart could be at risk, it wasn’t clear that she needed the paramedics.
“Do you want me to call an ambulance or do you want me to drive you to the ER?”
“I can walk to the car.” She said with assurance. She got out of bed. I pushed the walker to her. She toddled to the garage. I told the kids I was leaving. Called the teen girls home from the movie they had left see. Put Basil in charge. Grabbed the hospital bag. Met Mom at the garage door where she sat on the walker seat.
Five-minute drive to the hospital. I ran in for help. A nurse with a wheelchair came out to meet us. They took her straight back. Oxygen levels scary low. Fluid in lungs. Blood pressure high. Heart beats irregular. I haven’t asked the doctors, but there is no doubt in my mind that without intervention she wouldn’t have woken up on Tuesday morning.
She always tells people she is fine. The nurses asked, “How are you doing.” Mom said, “Not well.” She breathed like a percolating coffee pot. After being admitted that night first she was weak and then she was delirious. She fell out of her bed two days later going in search of her pony. Then came a day of weary sleep. After dialysis Tuesday, Wednesday and Thursday she had the Medicare cure where her peace and right mind concurred with the end of hospital stay covered by insurance. She had dialysis on Friday at the clinic and had her first full night of peaceful sleep at home Friday night.
I was exhausted when I dropped her off at the dialysis clinic on Friday. While mom was in the hospital the kids dropped from a stomach bug and took turns waking me up in the middle of the night to comfort them and clean up the messes.
It might have been the look on my face or the tone of my voice or the words I used. When I told the nurse that I needed to talk to someone about the miscommunication going on a case worker came to the waiting room and brought me back to the conference room. She and the head of the dialysis clinic met me at the conference table with pens and pads of paper and an incident report sheet. They listened to the whole story and a long line of complaints and wrote down what I said. I am not a doctor and should not be explaining doctor’s orders to technicians. They should have known that Mom hadn’t had dialysis and shouldn’t have turned us away. The doctor should determine what is best for mom’s arm. He knows her veins and there are no other options that will work for her situation. The techs must talk to the doctor and find out how to work with the fistula she has. They expressed anger, sympathy and determination. I left confident that things would change. That night the head nurse called me to apologize and made arrangements to talk to me once a week. This particular scenario won’t happen again.
We saw the cardiologist this week. Until this visit I hadn’t understood the weakness of her heart. The future is uncertain. She is doing much better. Aside from walking slower, she is back to normal. The walker is back in the corner of her bedroom except on dialysis days.
Mom leads a blessed and prayerful life. She and I have as much fun as we can fit in between housework and doctor appointments. I missed her in a painful and horrible way those days that she was in the hospital, but there was only five minutes of guilt and no regrets. We love each other and do our best to enjoy each day as it comes. I ask no more of either of us.
2019-01-26
By the grace of God and the strength of Mom’s great will to live, Mom is alive today. Over and over again it feels like her time is up, and yet she is still with me. I long to feel that I have more control, that with enough vigilance and care and foresight the right decisions will be made, mistakes averted, misunderstandings avoided, and Mom can live forever. Each crisis is an exercise in humility and acceptance. Someday Mom will die and there will be hindsight and helpful souls pointing out would’ve could’ve should’ve that might have changed the sad reality. I would tell that future me that Mom’s life is in God’s hands and doing what seems best in the moment is all that is asked of me.
Mom had a great time with my sister Kimmy with no mishaps except for one fall. When I came back though she was high maintenance. We came back on Saturday, took Kimmy and her kids to the airport on Sunday and hit the week running on Monday with Mom’s Bible study and dialysis. Tuesday school started up again and Mom had a chiropractor appointment in the morning. At lunch her tooth started hurting and the dentist was able to see her that afternoon. They referred her to a root canal specialist the next day who said that nothing was wrong, and we could wait to see if the pain went away.
Wednesday afternoon Mom came home early from dialysis because the needle had infiltrated causing internal muscular bleeding and swelling around her veins. It happens sometimes. She came home and went to bed. Thursday was her primary care physician appointment. He thought she might have fractured her knee during the fall and sent us to get an x-ray.
By Friday I was exhausted. Mike and I had a meeting at the kids’ school which was followed by an appointment with the collision repair shop that had worked on Esther’s car but left the backup sensors broken. I came home ready to spend the afternoon resting and was greeted at the door with a phone call. It was someone from the dialysis clinic.
“I was just calling to see if your mom had been seen by a vein specialist?”
“What?”
“She only had ten minutes of dialysis before she infiltrated, and we don’t want to see her again until she is seen by a doctor.”
I complained that no one had talked to me about this and worried that she hadn’t had a dialysis since Monday.
“Her numbers were good on Wednesday she should be fine until Monday or Tuesday. If she starts coughing, throws up or runs a fever then take her to the emergency room.”
The vein specialist had no Friday afternoon appointments open and couldn’t see her until Monday. Mom was thrilled to have a break from dialysis and a day home from appointments. I watched her all weekend. On Sunday afternoon I found her in the living room gazing at the Christmas tree which was still up.
“Are you okay, Mom?” I asked.
“Yes.”
“What are you doing?”
“I’m looking at the tree.” Her confused expression questioned the purpose of the harassing questions. I told myself to ease up and let her have her moment.
We saw the vein doctor on Monday who was frustrated that there was no communication with him from the dialysis techs. He explained to me how he wanted them to insert the needles, marked up her arm, and gave me a colored ultrasound picture of her veins to pass to the clinic. He performed a procedure to remove a small blockage and told us that her arm was good to go for dialysis that afternoon. Going into the appointment Mom was in great spirits and her blood pressure was normal. She left feeling exhausted and claimed that the procedure had taken a lot out of her.
From there we raced to the clinic and arrived an hour and a half to two hours past her start time. Two people came out of the back room. A woman who I didn’t recognize and a male nurse who I talk to almost every time I’ve come in. I talked about the appointment and tried to explain the doctor’s instructions. They asked me why I hadn’t approached the doctor about doing a more invasive procedure on her arm to make her fistula more user friendly. The answer was that no one had told me about such a procedure. I can’t remember exactly how the conversation went. I didn’t specifically say that she hadn’t had dialysis for a week. I didn’t get down on my knees and beg them to take her back. I wish I had.
They told me that they wouldn’t give her dialysis. I asked if Mom would be okay and the woman said that she had made arrangements for Mom to be seen on Tuesday even though it wasn’t her regular day. As it turns out the nurse I trusted had been on vacation the whole week before. No one told him that Mom hadn’t had dialysis since the previous Monday. He assumed that her visit to the specialist was a routine appointment and wasn’t worried about her missing one day of dialysis. I assumed they didn’t want to do dialysis either because it was so soon after the procedure to remove a blockage or because we were late. I assumed. He assumed. She assumed. Mom was tired as she often is after doctor appointments but showed no other sign of distress. She seemed normal to me.
By eight o’ clock on Monday evening the little kids were all tucked in bed with my phone on their dresser playing the audiobook, “Little House on the Prairie.” I changed into my fuzzy socks and lay down on my bed. Thoughts of laundry and dishes were banished with a longing to watch a movie as often happens when Mike is in San Diego. Instead I picked up a book. I was too tired to feel flustered when Jonah ran downstairs with the phone, eyes wide and told me that Nanama needed me.
The kids don’t always answer the phone when it rings and they are listening to their audiobook. Jonah recognized her picture on the caller ID and had the following conversation.
“Is something wrong?”
“Yes.”
Mom has no memory of making that call.
I went to her room expecting that her CPAP machine mask was twisted or her pill machine was low on batteries. She lay on the bed. Her mask off.
“Momma are you okay?”
“I…can’t…breathe. I need to go to the emergency room.” She was calm. Her breathing was labored, but not in a gasping shortness of breath. Something was wrong, but not knowing that her heart could be at risk, it wasn’t clear that she needed the paramedics.
“Do you want me to call an ambulance or do you want me to drive you to the ER?”
“I can walk to the car.” She said with assurance. She got out of bed. I pushed the walker to her. She toddled to the garage. I told the kids I was leaving. Called the teen girls home from the movie they had left see. Put Basil in charge. Grabbed the hospital bag. Met Mom at the garage door where she sat on the walker seat.
Five-minute drive to the hospital. I ran in for help. A nurse with a wheelchair came out to meet us. They took her straight back. Oxygen levels scary low. Fluid in lungs. Blood pressure high. Heart beats irregular. I haven’t asked the doctors, but there is no doubt in my mind that without intervention she wouldn’t have woken up on Tuesday morning.
She always tells people she is fine. The nurses asked, “How are you doing.” Mom said, “Not well.” She breathed like a percolating coffee pot. After being admitted that night first she was weak and then she was delirious. She fell out of her bed two days later going in search of her pony. Then came a day of weary sleep. After dialysis Tuesday, Wednesday and Thursday she had the Medicare cure where her peace and right mind concurred with the end of hospital stay covered by insurance. She had dialysis on Friday at the clinic and had her first full night of peaceful sleep at home Friday night.
I was exhausted when I dropped her off at the dialysis clinic on Friday. While mom was in the hospital the kids dropped from a stomach bug and took turns waking me up in the middle of the night to comfort them and clean up the messes.
It might have been the look on my face or the tone of my voice or the words I used. When I told the nurse that I needed to talk to someone about the miscommunication going on a case worker came to the waiting room and brought me back to the conference room. She and the head of the dialysis clinic met me at the conference table with pens and pads of paper and an incident report sheet. They listened to the whole story and a long line of complaints and wrote down what I said. I am not a doctor and should not be explaining doctor’s orders to technicians. They should have known that Mom hadn’t had dialysis and shouldn’t have turned us away. The doctor should determine what is best for mom’s arm. He knows her veins and there are no other options that will work for her situation. The techs must talk to the doctor and find out how to work with the fistula she has. They expressed anger, sympathy and determination. I left confident that things would change. That night the head nurse called me to apologize and made arrangements to talk to me once a week. This particular scenario won’t happen again.
We saw the cardiologist this week. Until this visit I hadn’t understood the weakness of her heart. The future is uncertain. She is doing much better. Aside from walking slower, she is back to normal. The walker is back in the corner of her bedroom except on dialysis days.
Mom leads a blessed and prayerful life. She and I have as much fun as we can fit in between housework and doctor appointments. I missed her in a painful and horrible way those days that she was in the hospital, but there was only five minutes of guilt and no regrets. We love each other and do our best to enjoy each day as it comes. I ask no more of either of us.